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  • Request For Workplace Accommodation Formsept 2017

Get Request For Workplace Accommodation Formsept 2017

RequestforWorkplaceAccommodationForm SubmitthecompletedformtoyourSupervisorand/orHumanResources To assist us in the assessment of your needs, please provide the details of the workplace accommodationyouarerequesting.Additionaldocumentationmayberequiredtofullyassess.

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Content to consider in body of letter: Identify yourself as a person with a disability. State that you are requesting accommodations under the ADA (or the Rehabilitation Act of 1973 if you are a federal employee) Identify your specific problematic job tasks. Identify your accommodation ideas.

I am experiencing the following difficulties in performing my job because of my disability: _______________________. I am writing to request that you ______________________ (state requested accommodation) because it will___________________________ (how it will help you do your job) as a reasonable accommodation.

Changing a regular work schedule or establishing a flexible leave policy may be a reasonable accommodation unless it would cause an undue hardship. Modified work schedules may include flexibility in work hours or the work week, or part-time work.

Content to consider in body of letter: Identify yourself as a person with a disability. State that you are requesting accommodations under the ADA (or the Rehabilitation Act of 1973 if you are a federal employee) Identify your specific problematic job tasks. Identify your accommodation ideas.

A provider letter can be written by a doctor, nurse, therapist, psychiatrist, case worker, social worker, or other professional familiar with your disability.

Sample Accommodation Request Letter: Mental Health I have been having medical issues that have affected my mood, sleep schedule, concentration, and focus. I would like to request accommodations so that I might be able to perform my job effectively before my performance starts to suffer.

Because of my disability, I need the following accommodations: [LIST ACCOMMODATIONS]. A medical provider has prescribed this accommodation for my disability. I would like to meet with you to discuss these and any other accommodations that will enable me to have an equal opportunity to live in and enjoy this residence.

An employer may use this form to document the determination of an employee's request for a reasonable accommodation under the Americans with Disabilities Act (ADA). The form is intended for private employers.

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© Copyright 1997-2025
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232